Impact of Gender Difference on Characteristics and Outcome of Chronic Hepatitis C

Gender difference in chronic hepatitis C (CHC) infection is not previously well studied. We aimed to analyze the effect of gender difference on the risk factors of CHC, disease progression, and outcome after oral direct acting antiviral (DAA) therapy. The study was conducted at Tropical Medicine and Gastroenterology Department, Sohag University, Egypt, in the period between 2018 and 2020. 775 patients were evaluated for hepatitis C virus (HCV) risk factors. Laboratory investigations, abdominal ultrasound and liver Shear wave elastography (SWE) were done. The patients were given antiviral therapy and followed up to assess the response and side effects of DAA therapy. 434 (56%) of study patients were males and 341 (44%) were females. Catching infection from blood transfusion and intravenous (IV) injection of tarter emetic was significantly higher in males, while catching infection from surgical operation was significantly higher in females. Hepatic fibrosis was significantly more extensive in males. Side effects were reported more in females. Sustained virological response (SVR) 12 was reported in 98.6%. Females had a slightly better SVR12 than males (99.4% versus 97.9%). In conclusion males were different from females in exposure to HCV risk factors. After introduction of blood screening and stoppage of parenteral anti-bilharzial therapy the risk of HCV infection could be greatly prevented in males, while the exposure of females to obstetric procedure is increasing nowadays which hides a risk of ongoing infection in females. So, HCV surveillance programs in females retain their importance in early detection and management of CHC. Although hepatic fibrosis progression was more in males, females were more liable to adverse events of DAA therapy. So, researchers should consider the gender of their patients in drug design and administration.